TMJ, Sleep Apnea


TMJ disorders create pain and/or tenderness in the temporomandibular joint (TMJ). The TM joint is located on each side of your head in front of your ears. Some patients live with temporomandibular dysfunction (TMD) for years before it becomes painful enough to cause them to seek help. Others contract the problem suddenly; usually by some trauma or blow to the head, face and/or neck region. But both types of patient can have very similar symptoms.

Even though a headache can be a sign of many kinds of health problems, frequent headaches are the most common complaints of TMD sufferers. Other common complaints can include clicking or popping jaw joints, pain when chewing or yawning, grinding or clenching your teeth, neck/shoulder pain, worn teeth, your teeth do not touch when you bite, "stiffness" in your jaw joints that makes it difficult to open or to close your mouth. Methods for successful diagnosis and treatment of TMD vary from patient to patient and treatment can take time and even the amount of time varies from patient to patient.

Dr Don has treated thousands of pain/TMD patients with conservative treatments yet is also adept with more advanced techniques. Some of his more conservative treatments include Dental Cranial Osteopathy for TMD and head/neck pain, Resultant Force Vectors of occlusion to maintain and correct dental occlusion. When necessary, Dr. Don is skilled with Orthopedics/Orthodontics treatment, which includes repositioning appliances for TMD. He also uses whole food nutrition from Standard Process, Inc. to support the body during treatment. Dr. Don is a Diplomate of the Academy of Craniofacial Pain and the Academy of Pain Management.

Resultant Force Vectors of Occlusion

Resultant Force Vectors of Occlusion (RFV) technique is a method of assessing and treating body pain and dysfunction. The postural muscles of the body exert forces on the jaw and teeth. The teeth, conversely, exert forces on the jaw and outward into the postural muscles. Muscle tension that exceeds the ability of the body to adapt can:

  • Reduce normal range of motion
  • Decrease local blood flow
  • Entrap neurovascular bundles
  • Inhibit lymphatic drainage and produce local pain.

RFV technique tries to identify the muscle dysfunction by functional testing and muscle palpation. The offending tooth or area is then identified and demonstrated to the patient. The dental bite (occlusion) is adjusted to correct the discrepancy. Dr. Don and Dr. Darryl utilize RFV with all restorative procedures and for addressing pain/dysfunction problems.

Dental Cranial Osteopathy

Dental Cranial Osteopathy is a refined and subtle type of osteopathic treatment that encourages the release of stresses and tensions throughout the body, including the head. It is a gentle yet extremely effective approach and may be used in a wide range of conditions for people of all ages, from birth to old age. The importance of the relationship between cranial osteopathy and dentistry cannot be overstated. Conditions affecting the mouth and teeth have a very direct effect on the rest of the body. The face is composed of a number of different bones. Some of these bones are very delicate, and they are intricately linked together in a very complex way. All the bones of the face, like those in the rest of the skull, are free to move very minutely, which they do in a gentle rhythmical way. This movement between the bones is important in maintaining drainage of the sinuses, and permitting the free passage of air through the nose. Trauma to the face may restrict the normal movement between the bones, and can have very wide reaching effects in the whole body. One of the most common causes of trauma is dental treatment. Dr. Don and Dr. Darryl ensure safe, comfortable dental treatment and include cranial evaluation as needed.

Sleep Apnea

Everyone needs quality sleep. Without quality sleep the body has trouble healing and the mind will not function properly. Studies show that we need 7½ - 9 hours of quality sleep to perform at our optimum. Less sleep than this will cause our quality of living to decrease over time.

The current diagnosis of obstructive sleep apnea (OSA) is determined by using polysomnography testing at a hospital or sleep clinic. There are also ambulatory sleep studies (at home) which are very accurate. Dr. Don utilizes oral appliance therapy for treatment of OSA and snoring. The mandibular repositioning appliance (MRA) moves the jaw forward and pulls the tongue out of the airway. Oral appliances are most effective in the treatment of mild to moderate sleep apnea although they do provide a treatment alternative for patients with severe OSA who cannot or will not tolerate positive airway pressure therapy (CPAP).

Utilizing state of the art Acoustic Reflection technology and 3D imaging, Dr. Don obtains reproducible objective measurements of the airway to aid in titration for airway orthotic construction. His ability to help snoring and airway related sleep disorder (ARSD) has enabled many to regain energy and obtain a better quality of life. Dr. Don treats most ARSD cases with FDA approved mandibular repositioning appliances (MRA) and Standard Process nutritional support. Life style changes are essential to successful treatment with airway related sleep disorders. Weight loss/conditioning will decrease the neck and body size. Also, stress on the heart and circulatory system is reduced resulting in a healthier body.

Watch-PAT 200

A unique ambulatory device, providing auto-analysis and auto-reporting for evaluating airway related sleep disorders in an un-attended home environment. The Watch-PAT 200 is a self-contained device that is worn on the wrist and uses a non-invasive finger mounted probe to measure the PAT signal. The recorded signals are stored on its built-in actigraph to be downloaded to a computer for automatic analysis utilizing proprietary algorithms. In addition to the PAT Signal, the Watch-PAT 200 records oxygen saturation and actigraphy. A fourth channel, pulse rate, is derived from the PAT Signal.

Eccovision Airway Assesment

The Eccovision provides a means to thoroughly and accurately assess the patient's airway. Completely painless and non-invasive, the Eccovision emits sound waves through a self-contained central processing unit comprised of two tools: the rhinometer and pharyngometer. They map the patient's nasal passages and pharyngeal airway, respectively, via a technique called 'acoustic reflection'. The results are on-screen graphs directly correlating to the physicality of the patient's nasal passages and pharyngeal airway. According to Hood Labs, the manufacturer of the Eccovision, the acoustic reflection technique 'utilizes a patented, state-of-the-art acoustic signal processing technology to provide graphical representations of airway patency as a function of distance from the airway opening'.